Organization Active NPI

Pilsen Medical Clinic & Associates, LLC

  • Family Medicine Physician
  • Elmhurst, IL
National Provider Identifier
1790039725
Registry record updated Aug 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PILSEN MEDICAL CLINIC & ASSOCIATES, LLC
Practice address
533 W North Ave Ste 101
Elmhurst, IL 60126-2100
Phone
(312) 738-3355
Fax
(312) 564-5252
NPI assigned
Oct 29, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Naseem Fatima, MDNPI 1710393210
Title
Owner
Phone
(925) 548-6644

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

533 W North Ave Ste 101
Elmhurst, IL 60126-2100

Mailing address

533 W North Ave Ste 101
Elmhurst, IL 60126-2100
Phone (312) 738-3355

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130506000027 IL Part B Supplier - Clinic/Group Practice 5294972501 Receives reassigned benefits from 8 practitioners
Practice locations: Hillside, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2343183Pilsen Medical Clinic & Associates533 W North Ave - Ste 101, Elmhurst, IL 60126Certificate of waiverMay 2, 2028

National Provider Directory

National Provider Directory

Locations

1870 S Blue Island Ave
Chicago, IL 60608
Phone (312) 564-5246

1870 S Blue Island Ave
Fl 2
Chicago, IL 60608
Phone (312) 492-9780

4415 Harrison St
Ste 247
Hillside, IL 60162
Phone (312) 738-3355

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17656/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1351468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785542400000",
    "number": "1790039725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 W NORTH AVE STE 101",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262100",
            "telephone_number": "312-738-3355",
            "fax_number": "312-564-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533 W NORTH AVE STE 101",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262100",
            "telephone_number": "312-738-3355",
            "fax_number": "312-564-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PILSEN MEDICAL CLINIC & ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-29",
        "last_updated": "2026-08-01",
        "certification_date": "2026-08-01",
        "status": "A",
        "authorized_official_last_name": "FATIMA",
        "authorized_official_first_name": "NASEEM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "925-548-6644",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.